Sleep quality, internet addiction and depressive symptoms among undergraduate students in Nepal.
Sleep quality, internet addiction and depressive symptoms among undergraduate students in Nepal.
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DOI：
10.1186/s12888-017-1275-5
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发表时间：
2017-03-21
期刊：
影响因子：
4.4
通讯作者：
Poudyal AK
中科院分区：
文献类型：
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作者：
Bhandari PM;Neupane D;Rijal S;Thapa K;Mishra SR;Poudyal AK
关于尼泊尔大学生抑郁、网瘾和睡眠质量差的证据几乎不存在。虽然睡眠质量，网络成瘾和抑郁症状之间的相互作用经常在研究中进行评估，但睡眠质量或网络成瘾是否在统计学上介导了其他两个变量之间的关联并没有得到很好的探讨。我们招收了来自尼泊尔奇旺和加德满都27个本科校园的984名学生。采用匹兹堡睡眠质量指数、杨氏网络成瘾测验和病人健康问卷9号分别评估这些学生的睡眠质量、网络成瘾和抑郁症状。我们在数据分析中包括了937名学生的回答，在删除了5%或更多字段缺失的问卷后。通过自助法，我们评估了网络成瘾在睡眠质量和抑郁症状之间的中介作用，以及睡眠质量在网络成瘾和抑郁症状之间的中介作用。总体而言，35.4%、35.4%和21.2%的学生在睡眠质量差、网络成瘾和抑郁方面的得分高于有效的临界值。睡眠质量与年龄较低、不饮酒、印度教徒、性活跃和前一年的考试失败有关。较高的网瘾与较低的年龄，性生活不活跃以及在前一年的委员会考试中失败有关。年龄较大、性生活不活跃、前一年考试不及格和学习年限较低的学生，抑郁症状更严重。网络成瘾在睡眠质量对抑郁症状的间接影响中占16.5%。另一方面，睡眠质量在统计学上介导了30.9%的网络成瘾对抑郁症状的间接影响。在目前的研究中，很大一部分学生符合睡眠质量差、网络成瘾和抑郁的标准。网络成瘾和睡眠质量对抑郁症状的间接影响都有很大比例的中介作用。然而，这项研究的横截面性质限制了对结果的因果解释。未来的纵向研究，在网络成瘾或睡眠质量的测量之前的抑郁症状，是必要的，建立在我们的理解抑郁症状的发展在学生。
Evidence on the burden of depression, internet addiction and poor sleep quality in undergraduate students from Nepal is virtually non-existent. While the interaction between sleep quality, internet addiction and depressive symptoms is frequently assessed in studies, it is not well explored if sleep quality or internet addiction statistically mediates the association between the other two variables. We enrolled 984 students from 27 undergraduate campuses of Chitwan and Kathmandu, Nepal. We assessed sleep quality, internet addiction and depressive symptoms in these students using Pittsburgh Sleep Quality Index, Young’s Internet Addiction Test and Patient Health Questionnaire-9 respectively. We included responses from 937 students in the data analysis after removing questionnaires with five percent or more fields missing. Via bootstrap approach, we assessed the mediating role of internet addiction in the association between sleep quality and depressive symptoms, and that of sleep quality in the association between internet addiction and depressive symptoms. Overall, 35.4%, 35.4% and 21.2% of students scored above validated cutoff scores for poor sleep quality, internet addiction and depression respectively. Poorer sleep quality was associated with having lower age, not being alcohol user, being a Hindu, being sexually active and having failed in previous year’s board examination. Higher internet addiction was associated with having lower age, being sexually inactive and having failed in previous year’s board examination. Depressive symptoms were higher for students having higher age, being sexually inactive, having failed in previous year’s board examination and lower years of study. Internet addiction statistically mediated 16.5% of the indirect effect of sleep quality on depressive symptoms. Sleep quality, on the other hand, statistically mediated 30.9% of the indirect effect of internet addiction on depressive symptoms. In the current study, a great proportion of students met criteria for poor sleep quality, internet addiction and depression. Internet addiction and sleep quality both mediated a significant proportion of the indirect effect on depressive symptoms. However, the cross-sectional nature of this study limits causal interpretation of the findings. Future longitudinal study, where the measurement of internet addiction or sleep quality precedes that of depressive symptoms, are necessary to build upon our understanding of the development of depressive symptoms in students.